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Job Requirements of Senior Admin-Appeals:
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Employment Type:
Contractor
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Location:
Virginia, US (Onsite)
Do you meet the requirements for this job?
Senior Admin-Appeals
Careers Integrated Resources Inc
Virginia, US (Onsite)
Contractor
Job Title: Senior Admin-Appeals
Location: Remote, VA 23219
Duration: 3-6 months+ (Possible Extension)
Hours of Operations: 9:00 am – 5:00 pm, EST
Required Skills:
Key Responsibilities:
Required Skills & Qualifications:
Experience:
Location: Remote, VA 23219
Duration: 3-6 months+ (Possible Extension)
Hours of Operations: 9:00 am – 5:00 pm, EST
Required Skills:
- We are seeking a detail-oriented and service-driven Administrative Specialist to support the operations of the New York Independent Dispute Resolution Program.
- This role is essential in ensuring accurate data management, timely communication, and compliance with regulatory standards under the New York Surprise Billing Laws.
Key Responsibilities:
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Data Collection & Analysis:
- Gather and review incoming documentation from treatment providers, healthcare facilities, program participants, laboratories, and health plans.
- Accurately input relevant data into internal systems to support case processing and program tracking.
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Client Communication:
- Respond promptly and professionally to inquiries from clients, health plans, providers, and enrollees.
- Provide updates on case status and clarify program-related questions via email and other communication channels.
Required Skills & Qualifications:
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Exceptional Attention to Detail:
- Precision is critical to ensure the integrity of shared information and maintain compliance with federal and state regulations.
- Accuracy helps prevent disputes and supports fair determinations.
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Customer Service Orientation:
- Demonstrated ability to communicate effectively and empathetically with diverse stakeholders in a fast-paced environment.
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Deadline-Driven Mindset:
- Comfortable working in a production-based setting with time-sensitive tasks and performance metrics.
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Technical Knowledge:
- Familiarity with CPT (Current Procedural Terminology) codes.
- Strong ability to interpret claim forms and Explanation of Benefits (EOBs).
- Understanding of the No Surprises Act and its impact on billing and dispute resolution processes.
Experience:
- Prior experience in healthcare administration, insurance claims processing, or regulatory compliance.
- Proficiency in data entry systems and Salesforce (preferred).
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